037-3 Wyo. Code R. § 3-4

Current through April 27, 2019

Section 3-4 - Statement of Completion and Description of Well for Domestic or Stock Watering Use Only (Form U.W. 7)

The registration of a domestic or stock well completed before May 24, 1969, should be submitted on U.W. 7. If submitted for this purpose, the form must be accompanied by the legally required Two Dollar ($2.00) filing fee. This same form is also used to submit final information on domestic or stock wells completed after May 24, 1969. When the form is used for a permitted well drilled after that date, all requested information must be completed. The Permit No., Water Division No., and U.W. District will be entered in the State Engineer's Office. The remainder of the form should be completed by the applicant as follows:

a. NAME OF WELL - If the form is being used to register a well, a short, distinctive name and number must be assigned to the well; for example: "Smith No. 1". If the form is used as a Statement of Completion for a permitted well, the name and number must be identical to the name and number on the permit.

b. ITEM 1 - "Owner" - If the land on which the well is located is owned by more than one party, all landowners must be named as co-owners.

c. ITEM 2 - "Address" - Mailing addresses must be shown for each respective owner.

d. ITEM 3 - "Agent to receive correspondence...." - If several parties are named as owners, one party must be designated as agent to receive correspondence.

e. ITEMS 4 through 7- These items are self-explanatory. On wells drilled before May 24, 1969, if the driller is unknown, this fact must be noted.

f. ITEM 8 -- "Means of conveyance, distance and direction to point of use . . . ." - Indicate distance and direction from the well to the point or points of use, and explain how the water is conveyed. If necessary, submit a diagram on a separate sheet of paper. An example of the type of entry here is: "Water is conveyed to stock tank 100' SW of the well by 1" buried plastic pipe."

g. ITEMS 9 through 11- Dates are required on all wells. The dates provided should be as accurate as possible, even though they are only good estimates.

• (1) The priority date for wells completed prior to May 24, 1969, and registered before December 31, 1972, will revert to the date the well was completed and the water beneficially used. (A well is not considered complete until the pumping facility has been installed.)

h. ITEMS 12 through 17 - If information relating to the well description, test data, pump data, casing record, and other well characteristics is not known, it should be obtained from the driller. If any of the information cannot be obtained for old wells, insert "not available" for that item, but provide a reasonable estimate whenever possible; however, Item 14 (Amount of Water being Used) must be completed for all wells.

i. ITEM 18 - "LOG OF WELL...." - The log (description of the type of rocks encountered during drilling) should be obtained from the driller. On older wells, if a log is not available, please so indicate. Logs must be submitted for all wells drilled after May 24, 1969.

j. ITEMS 19 and 20 - These items are self-explanatory.

k. WELL LOCATION (on the first page of form) - Locate the well by county, and specify the 40-acre tract, section, township and range. Mark the diagram accurately to show the well location in the small square representing 40 acres. The written description and the plat location must agree.

• (1) If two or more wells are located in the same 40 acres, a distance measurement between them must be shown; for example: "Smith No. 1 Well is 200' south and 100' west of Smith No. 2 Well".

• (2) If the well is located in a resurvey lot or tract, please give the resurvey lot or tract number and the original survey section number, township and range. This information can usually be obtained from the County Clerk's Office.

• (3) If the well is in a city, town, or platted subdivision, complete the information in the lower part of the WELL LOCATION block.

  Give the lot and block numbers, the name of the subdivision and its location; for example: "Lot 9, Block 6 of the North Hills Subdivision of Laramie County, NE Va NE Va Section 23, T.18N.,R.69W."

• (4) The location on a Statement of Completion for a permitted well must be identical with the location on the permit, or an explanation must be provided under "REMARKS".

• (5) If any of the information contained on the application form is no longer correct (such as the applicants name, address, etc.) a notation should be made in the "REMARKS" portion of the Statement of Completion providing the State Engineer's Office with the correct, current information.
  • 1. SIGNATURE - The application form must be signed and dated. Only an applicant or his agent may sign the form. If the well is owned by more than one individual, only one need sign.

037-3 Wyo. Code R. § 3-4